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Individual

DR. ROGER RAICHELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
160 N MIDLAND AVE, NYACK HOSPITAL, NYACK, NY 10960-1912
(845) 348-2862
Mailing address
43 KENSICO DR, 2ND FLOOR, MOUNT KISCO, NY 10549-1009
(914) 666-8866
(914) 666-6777

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
189329
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0006424
GHI
NY
01
010189329NY01
ANTH
NY
05
01524758
NY
01
040426011772
BHP
NY
01
13319642703
1199
NY
01
189329
HIP
NY
01
2999503
CIGNA
NY
01
319915
MVP
NY
01
41687
GHI HMO
NY
01
4494737
AETNA
NY
01
NY6798
PHS
NY
Enumeration date
08/02/2005
Last updated
07/08/2007
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